PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

Hoy et al in 1995-2000 (100) , and the Tiwi Coordinated Care Trials between 1997 and 2000. TheMRTP study aimed at reducing the progression to end stage renal failure in the Tiwi Islands.Treatment centred around use of the drug perindropril, blood pressure control, and attempts tocontrol blood glucose and lipid levels wherever appropriate (101, 102) . The trial demonstrated thatthe number of new people entering renal replacement programs, and overall death rates in thecommunity, could be reduced by meticulous attention to blood pressure control in people at risk(103) . The Tiwi Coordinated Care Trial shared much of the philosophy of the PCDS. Chennakesavanhas compared the group of people who were enrolled in the MRTP with those who had met thesame criteria at the start of the CCT but had not been enrolled in the MRTP, and were insteadmanaged using a coordinated care approach. The study by Chennakesavan provides the onlydirect comparison of a PCDS-like strategy (the CCT) with a different strategy for management ofchronic diseases within the same population (104) .During the first six months of the MRTP, the blood pressure of participants significantlydecreased, and as the trial progressed blood pressures remained stable at the lower level orincreased slightly. Similar falls in BP were not seen in the CCT cohort, but the BP tended to risegradually during the study period. At the end of the MRTP blood pressures were still lower thanfor the CCT. It is interesting to note that the trial did not show any improvement in diabeticmanagement, if anything the diabetics in the trial appeared to have worse control than those inthe CCT (24 per cent with HbA1C